Ovulatory Disorders :
occurs as a result of hormonal imbalance either within the hypothalamus,
the pituitary or in the ovaries. Common causes of this includes stress,
excessive weight loss or weight gain, and polycystic ovaries. Polycystic
ovaries (POC) can affect up to 30% of women with infertility problems.
The ovaries contain many tiny cysts and although the majority of women
with PCO have normal regular cycles and have no problems conceiving,
others may experience menstrual irregularities, fertility problems,
excessive growth of body hair, acne and obesity. Treatment usually involves
the use of drugs to correct the hormonal imbalance and stimulation of
the ovaries. Alternatively, laparoscopic ovarian drilling using diathermy
or laser may be performed.
Fallopian Tube Blockage :
occur as a result of previous infection or abdominal surgery complicated
by adhesions. Fluids collecting in the tube (hydrosalpinx) may become
a potential source of chronic infection and may also be detrimental
for the development and implantation of the embryos. Some blockages
can be treated surgically; otherwise IVF treatment might be the best
a condition where the tissue, which normally lines the uterus, is found
at other sites in the pelvis. Bleeding occurs from these tissues at
the time of menstruation causing pelvic pain and painful periods. Blood
filled cysts may develop within the ovaries (chocolate cysts) also pelvic
scarring may affect the motility or the potency of the fallopian tubes
leading to infertility.
of endometriosis is either medical using drug therapy or surgical treatment
either laparoscopically or by open surgery depending on the extent of
the disease. IVF is an appropriate treatment for infertility associated
with endometriosis where other methods have failed.
Cervical Factors :
women have antisperm antibodies within their cervical mucus or produce
very little unfavorable mucus at the time of ovulation which interferes
with sperm migration through the cervical canal. Hostile mucus may be
by passed by intrauterine insemination with or without superovulation.
Unexplained Infertility :
20 - 25% of infertile couples, caused by factors which cannot be assessed
by using conventional tests. It is not always possible to determine
if, the eggs are actually released from the follicles, if the fallopian
tubes are able to pick up the egg, if the sperm is capable of reaching
the site of fertilisation and fertilising the egg. Intrauterine insemination
using washed sperm suspended in culture medium combined with ovarian
stimulation offers a simple relatively non-invasive procedure. If pregnancy
does not occur within the three cycles alternative methods such as IVF
should be considered which will be both diagnostic and hopefully therapeutic.
Infertility Investigations :
monitored cycle to check for ovulation
Assisted Reproductive Techniques :
insemination (Intracervical or intrauterine) using husband's or
oocyte and sperm transfer ( POST )
vitro fertilization (IVF)
Intrafallopian transfer (GIFT)
sperm injection ( ICSI )
sperm retrieval, PESA, TESE or Vas aspiration
of embryos and frozen embryo replacement.
donation and an active Shared Egg Program
( HOST ) surrogacy